Ceritinib Aggravates Glycemic Control in Insulin-treated Patients with Diabetes and Metastatic ALK-positive Lung Cancer

• Published in: Internal Medicine Vol. 58; no. 6; pp. 817 - 820
• Main Authors: Sakuma, Ikki, Nagano, Hidekazu, Yoshino, Ichiro, Yokote, Koutaro, Tanaka, Tomoaki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.03.2019; Japan Science and Technology Agency
• Subjects: Aged; Anaplastic Lymphoma Kinase - metabolism; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Biomarkers - blood; Biomarkers, Tumor - metabolism; Blood glucose; Blood Glucose - metabolism; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - metabolism; Carcinoma, Non-Small-Cell Lung - pathology; Case Report; ceritinib; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Female; Glucose; Humans; Hyperglycemia; Hyperglycemia - blood; Hyperglycemia - chemically induced; Hyperglycemia - diagnosis; Hypoglycemic Agents - therapeutic use; Insulin; insulin resistance; Insulin secretion; Insulins - therapeutic use; Internal medicine; Lung cancer; Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Lung Neoplasms - metabolism; Lung Neoplasms - pathology; Lymphoma; Metastases; Metastasis; Neoplasm Metastasis; Non-small cell lung carcinoma; Protein-tyrosine kinase; Pyrimidines - adverse effects; Pyrimidines - therapeutic use; Secretion; Sulfones - adverse effects; Sulfones - therapeutic use; hyperglycemia; ceritinib; insulin resistance
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.1870-18

We herein report a 75-year-old woman with insulin-treated diabetes and metastatic anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer who received ceritinib, a second-generation ALK inhibitor, and achieved dramatic tumor reduction. However, her fasting blood glucose increased, particularly markedly in the first two weeks after ceritinib administration, and did not normalize even increasing the total insulin dose. After discontinuing ceritinib, her glucose levels rapidly reduced. Ceritinib can aggravate hyperglycemia in patients with diabetes who lack compensatory insulin secretion, due to its inhibitory effects on the insulin receptor. Careful monitoring for ceritinib-induced hyperglycemia should be performed, especially in the first two weeks after ceritinib administration.